肺结核并发糖尿病患者经强化治疗后痰菌阳性的相关因素分析

Correlative factors analysis on sputum positive patients with pulmonary tuberculosis complicated with diabetes mellitus after intensive treatment

目的探讨肺结核并发糖尿病患者经强化抗结核治疗后痰菌阳性的相关因素,为临床干预提供理论依据。方法 239例肺结核并发糖尿病患者均接受抗结核治疗,在强化治疗结束后根据痰菌检测结果分为痰菌阳性组(n=82)与痰菌阴性组(n=157);采用单因素分析、非条件logistic回归分析进行相关因素分析。结果单因素分析发现2组患者糖尿病病程、治疗前空腹血糖水平、治疗前血清白蛋白水平、强化治疗末期空腹血糖水平、肺结核病灶范围、肺结核空洞数目等比较差异有统计学意义(P<0.05)。非条件logistic回归分析发现糖尿病病程、治疗前空腹血糖水平、肺结核病灶范围是痰菌阳性的独立危险因素(P<0.05),而治疗前血清白蛋白水平是痰菌阳性的独立保护因素(P<0.05)。结论糖尿病病程、治疗前空腹血糖水平、肺结核病灶范围是肺结核并发糖尿病患者经强化抗结核治疗后痰菌阳性的独立危险因素,而治疗前血清白蛋白水平是其独立的保护因素。

Objective To investigate the correlative factors of sputum positive patients with pulmonary tuberculosis complicated with diabetes mellitus after intensive treatment,and to provide theoretical basis for clinical intervention.Methods Two hundred and thirty-nine patients with pulmonary tuberculosis complicated with diabetes mellitus were treated with anti-tuberculosis treatment,then according to the results of sputum detection after intensive treatment,the patients were divided into positive group（n=82） and negative group（n=157）.The correlative factors were analyzed by univariate analysis and unconditional Logistic regression analysis.Results The univariate analysis showed that there were statistically significant differences in the course of diabetes,fasting plasma glucose and serum albumin levels before treatment,fasting plasma glucose level in the final stage of intensive treatment,lesions range of pulmonary tuberculosis,number of pulmonary tuberculosis cavity between the two groups（P0.05）.The logistic regression analysis showed that the course of diabetes,fasting plasma glucose level before treatment and lesions range of pulmonary tuberculosis were independent risk factors of positive sputum examination（P0.05）,while the serum albumin level before treatment was an independent protective factor（P0.05）.Conclusion The course of diabetes,fasting plasma glucose level before treatment and lesions range of pulmonary tuberculosis are independent risk factors of sputum positive patients with pulmonary tuberculosis complicated with diabetes mellitus after intensive treatment,and the serum albumin level before treatment is an independent protective factor.